Medicare Telehealth Access Faces Uncertainty, Disproportionately Impacting people with Disabilities
The expiration of certain Medicare telehealth flexibilities on October 1st is creating notable disruption for patients and providers, particularly those serving individuals with disabilities. While behavioral health telehealth remains permanently covered due to a 2021 Congressional decision, access to other vital telehealth services is now in question, leading to concerns about continuity of care and equitable access to healthcare.
Data from the Centers for Medicare & Medicaid Services (CMS) highlights the importance of telehealth for beneficiaries with disabilities. Nearly 30% of Medicare recipients eligible due to disability utilized telehealth services in the first quarter of 2025, a figure substantially higher than the approximately 11% of those eligible based on age (65+).
This disruption is directly impacting patients like Charis Hill,a 38-year-old Northern California resident with ankylosing spondylitis,a chronic inflammatory disease. hill was recently informed that a scheduled telehealth appointment with their rheumatologist on October 7th would not be covered by Medicare. Hill, who relies on telehealth appointments every three to four months, is immunocompromised and hesitant to return to in-person visits due to safety concerns regarding mask protocols. Thay are now exploring choice coverage options,including Medicaid,and worry about potential loss of access to specialist care and necessary medications if a solution isn’t found.
The uncertainty also presents challenges for healthcare providers. Jeffrey Davis, a director at health policy consultant McDermott+, explains that while there’s anticipation of a potential retroactive fix from Congress, there’s no guarantee. Providers are grappling with the decision of whether to continue offering telehealth services without assured reimbursement. Some, lacking the financial capacity to absorb potential losses, have already ceased offering these services to Medicare beneficiaries. CMS advises providers to continue offering telehealth but to inform patients of potential non-coverage. Davis notes the resulting confusion among both patients and providers.
Efforts to address the situation are underway. A bill sponsored by Senator Brian Schatz (D-Hawaii) has garnered 65 co-sponsors – enough for passage in the Senate if brought to a vote. Though, the estimated $25 billion cost over ten years has proven to be a sticking point in a Congress frequently enough requiring offsets for healthcare spending.
A short-term government funding bill passed by the House included a provision to extend Medicare telehealth coverage for approximately seven weeks, coinciding with the length of the continuing resolution. However, this bill has faced opposition in the Senate, with Democrats seeking an extension of expiring health care subsidies for individuals purchasing insurance in the individual market.
Despite the current challenges, advocates like Zebley express hope that the disruption will galvanize support for making Medicare telehealth coverage permanent, possibly leading to a bipartisan solution with the support of President Trump and Congress.